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Pediatric Foot Disorders

Should I be concerned about the way my small child walks?

Parents are concerned about the well-being and growth of their children. Often times the parent wore corrective shoes as a child or now has problems with their feet or ankles and wonders if their child will have the same fate.

Below is a list of common concerns, what is considered normal, and when to seek our help.

Flat Feet

This condition is often referred to as pronation. All people pronate to some degree, but excessive pronation can lead to problems such as bunions and heel pain in adults. A large part of this tendency to pronate is inherited from the parents. It is normal for children to be flat footed up until the age of 6 years because of how the baby is positioned in utero and the development of the feet and legs after birth. If your child is over 6 years old, has one foot that is positioned much differently than the other foot, complains of pain or night cramps, or if a family member has had problems due to flat feet, you should see your podiatrist.

Toe Walking

Toe walking can normally be found in early walkers. Children should, however, start to walk heel to toe after 6 months of walking. If toe walking persists, you should always see a podiatrist to rule out an underlying neurological or musculoskeletal condition.

Bow Legs

At birth, infants have a small degree of bowing in their legs because of their position in the womb. This condition is usually temporary and the child will outgrow the bow legs by age 2 years. If the child still has bowing past 3 years, you should see your podiatrist.

Knock Knee

Knock knee is also a part of normal development of a child’s growth. This condition usually starts at about age 2 and reaches its maximum at about age 4 years. It tends to disappear at age 6 or 7 years. If this condition is accompanied by foot, ankle, or knee pain or excessive tripping, or one leg looks much different than the other, see your podiatrist.


The tendency to be in-toed (pigeon toed), like many of the previous conditions discussed, is inherited from the parents. A mild degree of in-toeing is perfectly normal. In fact, many professional athletes in-toe. Many children will outgrow this tendency by age 7 or 8 years. Some in-toeing is due to the position of the foot bones at birth. If your child is born with his or her toes pointed in and the foot forms a “C” shape when viewed from the bottom, seeing your podiatrist earlier may make it easier to correct this condition. When your child is older, if they trip often or complain of foot or leg pain, see your podiatrist.

When these treatment options are no longer providing the comfort you need, consultation with your podiatric physician is advised to discuss surgical options.

High Heels

Alternating high heels with lower ones enables your physique to adapt and benefit from the plus-points of all heel heights.
According to podiatrist Jon H. Sherman, totally flat shoes are not the ideal for overall health of the feet or legs: a small heel is better. “Low heels of half to three quarters of an inch are good for both the front and back of the foot,” he says.

“Small heels not only help reduce tension in tendons and ligaments around the foot, they also help the calf muscles – which are tight in many women – to relax.” Higher heels (11/2in-21/2in) are best worn for limited periods, say around three to eight hours, providing you are having sitting breaks for half that time. At other times, wear lower heels.

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